Original Article
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Impact of gestational risk factors on maternal cardiovascular system María Perales1,2, Alejandro Santos-Lozano1,3, Fabian Sanchis-Gomar1, María Luaces4, Helios ParejaGaleano1,5, Nuria Garatachea1,6, Rubén Barakat7*, Alejandro Lucia1,5* 1
Research Institute, Hospital 12 de Octubre (‘i+12’), Madrid, Spain; 2Camilo Jose Cela University, Madrid, Spain; 3GIDFYS, Department of Health
Sciences, European University Miguel de Cervantes, Valladolid, Spain; 4Hospital Clínico San Carlos, Madrid, Spain; 5European University, Madrid, Spain; 6Facultad de Ciencias de la Salud y del Deporte, GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón -IA2- (Universidad de Zaragoza-CITA), Zaragoza, Spain; 7AFIPE Research Group, Technical University of Madrid, Madrid, Spain Contributions: (I) Conception and design: M Perales, F Sanchis-Gomar, A Lucia, N Garatachea, R Barakat; (II) Administrative support: N Garatachea, H Pareja-Galeano; (III) Provision of study materials or patients: M Luaces, H Pareja-Galeano; (IV) Collection and assembly of data: M Luaces, R Barakat; (V) Data analysis and interpretation: M Perales, A Santos-Lozano, A Lucia, F Sanchis-Gomar; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. *These authors contributed equally for the senior authorship. Correspondence to: Fabian Sanchis-Gomar, MD, PhD. Research Institute of Hospital 12 de Octubre (‘i+12’), 6th Floor, Laboratories Sector, CAA Building, Avda. de Córdoba s/n, 28041 Madrid, España. Email: [email protected].
Background: Scarce evidence is available on the potential cardiovascular abnormalities associated with some common gestational complications. We aimed to analyze the potential maternal cardiac alterations related to gestational complications, including body mass index (BMI) >25 kg/m2, gaining excessive weight, or developing antenatal depression.
Methods: The design of this study was a secondary analysis of a randomized controlled trial. Echocardiography was performed to assess cardiovascular indicators of maternal hemodynamic, cardiac remodeling and left ventricular (LV) function in 59 sedentary pregnant women at 20 and 34 weeks of gestation.
Results: Starting pregnancy with a BMI >25 kg/m2, gaining excessive weight, and developing antenatal depression had no cardiovascular impact on maternal health (P value >0.002). Depressed women were more likely to exceed weight gain recommendations than non-depressed women (P value 25 kg/m2, gaining excessive weight, and developing antenatal depression, based on echocardiographic indicators of maternal hemodynamics, cardiac remodeling and LV function. We hence hypothesized that these complications may alter the maternal cardiovascular system during pregnancy. Methods Study characteristics The present study was a secondary analysis of a randomized controlled trial (clinicaltrials.gov identifier NCT01723098) performed from February 2009 to March 2013 (15). Informed consent was obtained from all enrolled participants. The study was approved by the Research Ethics Committee of the Hospital Universitario de Fuenlabrada (Madrid, Spain; approval number 240/09) and was in accordance with the ethical guidelines of the Declaration of Helsinki (modified in 2008). Only those healthy pregnant women (n=121) who were randomly allocated to the standard care program group in the aforementioned trial were included in the present study. They met the following inclusion criteria: (I) having no obstetric or medical complications (based on the American college of obstetricians and gynecologists guidelines
© Annals of Translational Medicine. All rights reserved.
Perales et al. Gestational risk factors and cardiovascular adaptations
(ACOG) (16); (II) time of pregnancy 11.5 kg; non-risk ≤11.5 kg; and “obese” women (pre-gestational BMI ≥30 kg/m2) weight gain: risk >9 kg; non-risk ≤9 kg; (III) Antenatal depression was assessed by the center for epidemiological studies depression (CESD) scale: risk (depressed women) = CESD score ≥16; non-risk (non-depressed women) = CESD score
Page 1 of 15
Impact of gestational risk factors on maternal cardiovascular system María Perales1,2, Alejandro Santos-Lozano1,3, Fabian Sanchis-Gomar1, María Luaces4, Helios ParejaGaleano1,5, Nuria Garatachea1,6, Rubén Barakat7*, Alejandro Lucia1,5* 1
Research Institute, Hospital 12 de Octubre (‘i+12’), Madrid, Spain; 2Camilo Jose Cela University, Madrid, Spain; 3GIDFYS, Department of Health
Sciences, European University Miguel de Cervantes, Valladolid, Spain; 4Hospital Clínico San Carlos, Madrid, Spain; 5European University, Madrid, Spain; 6Facultad de Ciencias de la Salud y del Deporte, GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón -IA2- (Universidad de Zaragoza-CITA), Zaragoza, Spain; 7AFIPE Research Group, Technical University of Madrid, Madrid, Spain Contributions: (I) Conception and design: M Perales, F Sanchis-Gomar, A Lucia, N Garatachea, R Barakat; (II) Administrative support: N Garatachea, H Pareja-Galeano; (III) Provision of study materials or patients: M Luaces, H Pareja-Galeano; (IV) Collection and assembly of data: M Luaces, R Barakat; (V) Data analysis and interpretation: M Perales, A Santos-Lozano, A Lucia, F Sanchis-Gomar; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. *These authors contributed equally for the senior authorship. Correspondence to: Fabian Sanchis-Gomar, MD, PhD. Research Institute of Hospital 12 de Octubre (‘i+12’), 6th Floor, Laboratories Sector, CAA Building, Avda. de Córdoba s/n, 28041 Madrid, España. Email: [email protected].
Background: Scarce evidence is available on the potential cardiovascular abnormalities associated with some common gestational complications. We aimed to analyze the potential maternal cardiac alterations related to gestational complications, including body mass index (BMI) >25 kg/m2, gaining excessive weight, or developing antenatal depression.
Methods: The design of this study was a secondary analysis of a randomized controlled trial. Echocardiography was performed to assess cardiovascular indicators of maternal hemodynamic, cardiac remodeling and left ventricular (LV) function in 59 sedentary pregnant women at 20 and 34 weeks of gestation.
Results: Starting pregnancy with a BMI >25 kg/m2, gaining excessive weight, and developing antenatal depression had no cardiovascular impact on maternal health (P value >0.002). Depressed women were more likely to exceed weight gain recommendations than non-depressed women (P value 25 kg/m2, gaining excessive weight, and developing antenatal depression, based on echocardiographic indicators of maternal hemodynamics, cardiac remodeling and LV function. We hence hypothesized that these complications may alter the maternal cardiovascular system during pregnancy. Methods Study characteristics The present study was a secondary analysis of a randomized controlled trial (clinicaltrials.gov identifier NCT01723098) performed from February 2009 to March 2013 (15). Informed consent was obtained from all enrolled participants. The study was approved by the Research Ethics Committee of the Hospital Universitario de Fuenlabrada (Madrid, Spain; approval number 240/09) and was in accordance with the ethical guidelines of the Declaration of Helsinki (modified in 2008). Only those healthy pregnant women (n=121) who were randomly allocated to the standard care program group in the aforementioned trial were included in the present study. They met the following inclusion criteria: (I) having no obstetric or medical complications (based on the American college of obstetricians and gynecologists guidelines
© Annals of Translational Medicine. All rights reserved.
Perales et al. Gestational risk factors and cardiovascular adaptations
(ACOG) (16); (II) time of pregnancy 11.5 kg; non-risk ≤11.5 kg; and “obese” women (pre-gestational BMI ≥30 kg/m2) weight gain: risk >9 kg; non-risk ≤9 kg; (III) Antenatal depression was assessed by the center for epidemiological studies depression (CESD) scale: risk (depressed women) = CESD score ≥16; non-risk (non-depressed women) = CESD score
